Differences between teams' models of care
Team | Geography | Number of decedents 2009–2011 | Median time on service (days) | Palliative care physicians FTE (funding source) | Nurses FTE (funding source) | Other team members FTE (funding source) | Main model of care* | |||
---|---|---|---|---|---|---|---|---|---|---|
1 | Urban | 830 | 40 | 1 | (FFS billing) | 8 | (Regional health authority) | 2 | (Regional health authority) | Substitution |
2 | Suburban | 221 | 53 | 3 | (FFS billing) | 3.5 | (Regional health authority) | 5 | (Community fundraising and regional health authority) | Substitution |
3 | Suburban | 144 | 38 | 1 | (FFS billing) | 1 | (Homecare coordinating agency) | 0.6 | (Homecare coordinating agency) | Mixed |
4 | Suburban | 125 | 40 | 1 | (FFS billing) | 2 | (Homecare coordinating agency) | 1 | (Homecare coordinating agency) | Mixed |
5 | Suburban | 105 | 36 | 0.5 | (FFS billing) | 1 | (Homecare coordinating agency) | 0.2 | (Community fundraising) | Shared care |
6 | Rural | 90 | 63 | 2 | (Alternative payment plan) | 2 | (Homecare coordinating agency) | 1.2 | (Local primary care team) | Mixed |
7 | Urban | 676 | 45 | 11.5 | (Alternative payment plan) | 1 | (Hospital and community fundraising) | 5.9 | (Physician's alternative payment plan) | Substitution |
8 | Suburban | 497 | 49 | 2 | (FFS billing and alternative payment plan) | 2 | (Homecare coordinating agency) | 1 | (Homecare coordinating agency) | Substitution |
9 | Urban | 775 | 38 | 1.3 | (FFS billing) | 3 | (Regional health authority) | 1.7 | (Local hospital) | Consultation |
10 | Rural | 268 | 23 | 0.6 | (Alternative payment plan) | 1 | (Homecare coordinating agency) | 2.5 | (Local hospital and homecare coordinating agency) | Shared care |
11 | Rural | 181 | 32 | 6 | (FFS billing) | 2 | (Community fundraising) | 4.7 | (Community fundraising and local hospital) | Shared care |
FFS, fee-for-service, that is, physician bills for each aspect of care and service they provide according to a set price mechanism.
Alternative payment plan, that is, physician reimbursement is a combination of FFS and salary.
*We used Pereira's framework13 which depicts a spectrum of models of care ranging from: (1) substitution (specialist provider takes on full responsibility for care and family physician is no longer involved); to (2) shared care (decision-making is shared between specialist provider and family physician); to (3) consultation (family physician has full responsibility for decision-making and asks specialist for advice on a particular issue).
FTE, full time equivalent.